Cholesterol and Atherosclerosis

IdealJoe

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Minuteman
  • Feb 16, 2017
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    The other thread got taken over by anti-medicine howler monkeys and I think many here could benefit from some additional information. I tested high for cholesterol and since I don't trust doctors, or most anyone, I've been researching this topic for several months to make an informed decision about course of action for myself. The topic seems to be extremely complex and far from settled science. Some of my takeaways are:

    The disease is largely genetic.
    Standard lipid panels tell little about your true risks.
    Most treatment protocols are using very dated understandings.
    "Good cholesterol", HDL, is largely irrelevant.
    "Bad cholesterol", LDL, is a small measurement of risk.
    Statins were a best treatment approach for a long time but lacked understanding.
    Anti PCSK9 inhibitors seem to be a very promising breakthrough and an alternative to statins.
    If you are genetically at high risk you better get on top of it at a young age long before symptoms.

    Here is an article I came across today that does a good job at summarizing some of the latest understandings. https://www.msn.com/en-us/health/ot...1&cvid=b6eb6a7970a24495b61f92d71d4cd3ca&ei=35

    Some of the most credible information I came across, (best I can tell), was from Dr. Peter Attia. https://peterattiamd.com/ He has a podcast on the subject of cholesterol that's like 7 hours long. For anyone that wants it explained in detail from the early history of Lipid research to some of the latest studies, I highly recommend it. It really educated me to the point I know my Doc doesn't have a good understanding on the subject and my health is in my own hands.
     
    The other thread got taken over by anti-medicine howler monkeys and I think many here could benefit from some additional information. I tested high for cholesterol and since I don't trust doctors, or most anyone, I've been researching this topic for several months to make an informed decision about course of action for myself. The topic seems to be extremely complex and far from settled science. Some of my takeaways are:

    The disease is largely genetic.
    Standard lipid panels tell little about your true risks.
    Most treatment protocols are using very dated understandings.
    "Good cholesterol", HDL, is largely irrelevant.
    "Bad cholesterol", LDL, is a small measurement of risk.
    Statins were a best treatment approach for a long time but lacked understanding.
    Anti PCSK9 inhibitors seem to be a very promising breakthrough and an alternative to statins.
    If you are genetically at high risk you better get on top of it at a young age long before symptoms.

    Here is an article I came across today that does a good job at summarizing some of the latest understandings. https://www.msn.com/en-us/health/ot...1&cvid=b6eb6a7970a24495b61f92d71d4cd3ca&ei=35

    Some of the most credible information I came across, (best I can tell), was from Dr. Peter Attia. https://peterattiamd.com/ He has a podcast on the subject of cholesterol that's like 7 hours long. For anyone that wants it explained in detail from the early history of Lipid research to some of the latest studies, I highly recommend it. It really educated me to the point I know my Doc doesn't have a good understanding on the subject and my health is in my own hands.
    I’m on pcsk9 inhibitors and it’s the only thing that helped my cholesterol numbers in fact it knocked the shit out of them
     
    I’d watch what you call credible, he has never been board certified.

    He’s another guy saying that taking extra vitamin c will make you live 5 years longer

    I have and still do manufactured products with many doctors and companies with the same theory.

    While it might have merit…when they get cancer they all get chemo because they know upping their dose of “L-tyrosine” won’t do anything.

    He’s a life style coach which in itself is a huge benefit. If everyone ate better and lost 30 pounds they’d be healthier in general.

    Not being a downer but there is very limited properly performed clinical studies on those ideas
     
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    I’d watch what you call credible, he has never been board certified.

    He’s another guy saying that taking extra vitamin c will make you live 5 years longer

    I have and still do manufactured products with many doctors and companies with the same theory.

    While it might have merit…when they get cancer they all get chemo because they know upping their dose of “L-tyrosine” won’t do anything.

    He’s a life style coach which in itself is a huge benefit. If everyone ate better and lost 30 pounds they’d be healthier in general.

    Not being a downer but there is very limited properly performed clinical studies on those ideas
    I'm not trying to say Attia is the credible researcher. I know he is into all kinds of things related to life longevity. I have no knowledge to his credibility there. He described Dr. Thomas Dayspring as his mentor on the lipidology topic and one of his podcast Sessons was with Dayspring which confirmed to me Attia's understanding was correct. At least agreed with Dayspring who does seem certifiably credible. https://www.pri-med.com/globals/faculty/d/dayspring-thomas?refurl=www.bing.com
     
    I got on top of my cholesterol, etc through dietary changes I made - it helped a great deal and has kept me off meds close to a decade now.

    The right meds can help and research in this area continues. I hang out with a couple of cardiologists quite a bit and have discussed the meds at length - they are a management tool for cholesterol rather than a magic pill. Not everyone is the same in terms of treatments and outcomes. They do have side effects to be aware of though the bad stuff is pretty rare and should be caught early if you're being monitored by your doc as anyone on meds should be doing.

    The bizarre is the retreads among us who are fat and out of shape but won't take meds or do anything about their condition because "muh meat... and muh taters... exercise hurts my _______"

    How weak. Can't fix stupid and they'll just die younger than they should. Sucks for their kids and grandkids.
     
    I don't post much but read a lot. I started paying very close attention to these last couple of threads. I have been in the hospital with my wife and have had a lot of time to read post on the hide. She had a stroke that affected her right side. Speech, arm and legs on the 21st of June. They did an MRI and put her on blood thinner and 80 mg of some kind of statin. Supposed to go home today and I am heading to CVS to fill scripts. She is a nonsmoker, doesn't drink, 55, little overweight, tries to walk a mile or so in the cow pasture every other night, so this was a pretty big shock. She can walk with a walker about 100' and is getting better at talking, right arm not so much. Hart is fine, low blood pressure, blaming it on high cholesterol. She had a clot in the back, left side of the brain. I will keep reading to try and understand more.
     
    I don't post much but read a lot. I started paying very close attention to these last couple of threads. I have been in the hospital with my wife and have had a lot of time to read post on the hide. She had a stroke that affected her right side. Speech, arm and legs on the 21st of June. They did an MRI and put her on blood thinner and 80 mg of some kind of statin. Supposed to go home today and I am heading to CVS to fill scripts. She is a nonsmoker, doesn't drink, 55, little overweight, tries to walk a mile or so in the cow pasture every other night, so this was a pretty big shock. She can walk with a walker about 100' and is getting better at talking, right arm not so much. Hart is fine, low blood pressure, blaming it on high cholesterol. She had a clot in the back, left side of the brain. I will keep reading to try and understand more.
    Good luck to you and your bride. GodSpeed.
     
    38, non-smoker, non-drinker, a little soft but not out of shape by any means, always had pretty active jobs, scuba dive, used to ride a bike pretty regularly, shot all kinds of local 2-gun competitions, etc. However I did have mildly elevated BP and cholesterol despite all my efforts. Neither were high enough for my PCP to be concerned. I do use a CPAP, but again, I’m not horribly out of shape or overweight. If you saw me, you’d think I was pretty healthy for a guy my age.

    But I go in for my fourth cath/angiogram in 15 months in a week and a half. My calcium score is off the charts bad. I have three stents and anticipate a fourth with this upcoming procedure. Finding all this out was a shock, and I’ve surprised my cardiologists every step of the way.

    I’m apparently genetically predisposed to these issues, as there’s no other explanation. I don’t know when I’ll die, but short of an accident or some accelerated cancer, I’ll die from a heart attack or heart failure. Despite doing better than most at taking care of myself and having a reasonable diet. I just drew the shittiest/shortest straw for this stuff.

    I’m on all the meds and have been religiously for the past 15 months, but I’m still having significant problems. Sometimes you don’t have to be a fat, lazy bastard to have problems. You just get it up the ass from life. 🤷‍♂️ If statins buy me another 10-15 years to help take care of my wife, I’ll consider myself blessed. Or cursed. Having a hard time some days deciding which it is lol…
     
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    38, non-smoker, non-drinker, a little soft but not out of shape by any means, always had pretty active jobs, scuba dive, used to ride a bike pretty regularly, shot all kinds of local 2-gun competitions, etc. However I did have mildly elevated BP and cholesterol despite all my efforts. Neither were high enough for my PCP to be concerned. I do use a CPAP, but again, I’m not horribly out of shape or overweight. If you saw me, you’d think I was pretty healthy for a guy my age.

    But I go in for my fourth cath/angiogram in 15 months in a week and a half. My calcium score is off the charts bad. I have three stents and anticipate a fourth with this upcoming procedure. Finding all this out was a shock, and I’ve surprised my cardiologists every step of the way.

    I’m apparently genetically predisposed to these issues, as there’s no other explanation. I don’t know when I’ll die, but short of an accident or some accelerated cancer, I’ll die from a heart attack or heart failure. Despite doing better than most at taking care of myself and having a reasonable diet. I just drew the shittiest/shortest straw for this stuff.

    I’m on all the meds and have been religiously for the past 15 months, but I’m still having significant problems. Sometimes you don’t have to be a fat, lazy bastard to have problems. You just get it up the ass from life. 🤷‍♂️ If statins buy me another 10-15 years to help take care of my wife, I’ll consider myself blessed. Or cursed. Having a hard time some days deciding which is it lol…
    Damn, that's rough. Sorry you drew the short straw on the topic.

    My understanding is with someone like you, the problem can start in your teens. For many it starts later. Proper care and meds can prolong the disease a long time. But doctors aren't testing for these conditions. They talk about 10 year risk factors and such and rely on cholesterol tests which have nothing really to do with what your body does with that cholesterol. As was said above, PCSK9 inhibitors can really knock your bad cholesterol down. Combined with a healthy diet they theorize there could be some reversing effects but not proven.

    That Dr. Dayspring I referenced talked about a study he did where Lipid tests were given at intervals while eating fatty foods. He found people metabolize cholesterol in different ways. He compared it to how a diabetics system deals with sugar vs a healthy person. Some peoples cholesterol spikes while eating high fat food and others remain normal. The standard lipid test has you fast before the test. So someone with low LDL and/or high HDL isn't necessarily in the clear. And the reverse doesn't mean you have a big problem.
     
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    Changing all red meat (virtually all) to wild game dropped my cholesterol over 30 points, and dropped my wife's score over 60 points. She has hereditary cholesterol issues, and had higher numbers than me to start.

    A friend with cancer has a holistic doctor who has told him "no grocery store meat". Organic, grass fed/finished only. I send him home with at least one deer every year, and wild hog when I can get it.
     
    Changing all red meat (virtually all) to wild game dropped my cholesterol over 30 points, and dropped my wife's score over 60 points. She has hereditary cholesterol issues, and had higher numbers than me to start.

    A friend with cancer has a holistic doctor who has told him "no grocery store meat". Organic, grass fed/finished only. I send him home with at least one deer every year, and wild hog when I can get it.
    The other thread got taken over by anti-medicine howler monkeys and I think many here could benefit from some additional information. I tested high for cholesterol and since I don't trust doctors, or most anyone, I've been researching this topic for several months to make an informed decision about course of action for myself. The topic seems to be extremely complex and far from settled science. Some of my takeaways are:

    The disease is largely genetic.
    Standard lipid panels tell little about your true risks.
    Most treatment protocols are using very dated understandings.
    "Good cholesterol", HDL, is largely irrelevant.
    "Bad cholesterol", LDL, is a small measurement of risk.
    Statins were a best treatment approach for a long time but lacked understanding.
    Anti PCSK9 inhibitors seem to be a very promising breakthrough and an alternative to statins.
    If you are genetically at high risk you better get on top of it at a young age long before symptoms.

    Here is an article I came across today that does a good job at summarizing some of the latest understandings. https://www.msn.com/en-us/health/ot...1&cvid=b6eb6a7970a24495b61f92d71d4cd3ca&ei=35

    Some of the most credible information I came across, (best I can tell), was from Dr. Peter Attia. https://peterattiamd.com/ He has a podcast on the subject of cholesterol that's like 7 hours long. For anyone that wants it explained in detail from the early history of Lipid research to some of the latest studies, I highly recommend it. It really educated me to the point I know my Doc doesn't have a good understanding on the subject and my health is in my own hands.
    Thanks for you getting the discussion started.

    A couple decades ago my PCP told me that I was creeping up on bad cholesterol numbers. Six months later I came in 15lbs lighter & had traded some fat for toned musculature & better cardio. My total cholesterol number had also dropped 15 points. Unfortunately, knowing what to do doesn't always translate into doing it. Here I am now, having been consuming statins for 5+ years. Cardiologist checkup today so that I can feel safe getting back to it.

    Keith
     
    I don't post much but read a lot. I started paying very close attention to these last couple of threads. I have been in the hospital with my wife and have had a lot of time to read post on the hide. She had a stroke that affected her right side. Speech, arm and legs on the 21st of June. They did an MRI and put her on blood thinner and 80 mg of some kind of statin. Supposed to go home today and I am heading to CVS to fill scripts. She is a nonsmoker, doesn't drink, 55, little overweight, tries to walk a mile or so in the cow pasture every other night, so this was a pretty big shock. She can walk with a walker about 100' and is getting better at talking, right arm not so much. Hart is fine, low blood pressure, blaming it on high cholesterol. She had a clot in the back, left side of the brain. I will keep reading to try and understand more.
    First name for you and your wife? Helps for prayers.
    We have a good group that tries to help in whatever belief we all have.
     
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    First name for you and your wife? Helps for prayers.
    We have a good group that tries to help in whatever belief we all have.
    James and Susan
     
    The other thread got taken over by anti-medicine howler monkeys and I think many here could benefit from some additional information.

    You are quite wrong in your overgeneralization. Many of us are pro medications that can benefit people, just against the over a prescription of certain classes of medications. Some of us applaud new medications that are actually go through clinical trials without manipulation of data, and aren't over-applied by changing criteria of what is considered pathological.

    More importantly the concern should be on not using medicines as a quick fix as opposed to healthy lifestyle, especially in regards to good food choices. Unfortunately, many of us do not have the same access to non-organic, non-GMO products that those who have those prepaid debit cards have access to.
     
    38, non-smoker, non-drinker, a little soft but not out of shape by any means, always had pretty active jobs, scuba dive, used to ride a bike pretty regularly, shot all kinds of local 2-gun competitions, etc. However I did have mildly elevated BP and cholesterol despite all my efforts. Neither were high enough for my PCP to be concerned. I do use a CPAP, but again, I’m not horribly out of shape or overweight. If you saw me, you’d think I was pretty healthy for a guy my age.

    But I go in for my fourth cath/angiogram in 15 months in a week and a half. My calcium score is off the charts bad. I have three stents and anticipate a fourth with this upcoming procedure. Finding all this out was a shock, and I’ve surprised my cardiologists every step of the way.

    I’m apparently genetically predisposed to these issues, as there’s no other explanation. I don’t know when I’ll die, but short of an accident or some accelerated cancer, I’ll die from a heart attack or heart failure. Despite doing better than most at taking care of myself and having a reasonable diet. I just drew the shittiest/shortest straw for this stuff.

    I’m on all the meds and have been religiously for the past 15 months, but I’m still having significant problems. Sometimes you don’t have to be a fat, lazy bastard to have problems. You just get it up the ass from life. 🤷‍♂️ If statins buy me another 10-15 years to help take care of my wife, I’ll consider myself blessed. Or cursed. Having a hard time some days deciding which it is lol…

    Yes, you should be on statins or Repatha.
     
    There is a correlation between industrial farming and an increase in heart disease, diabetes, cancer and general metabolic disease. Carbs convert to sugar, sugar causes inflammation. Carbs/sugar are in much of our food. Add some seed oils and alcohol and it's no wonder we are so sick. For the most part, I don't think the medical community (especially pharmaceutical companies) have any interest in improving our health. They need to make pills ($$$$) for sick people.
     
    I got on top of my cholesterol, etc through dietary changes I made - it helped a great deal and has kept me off meds close to a decade now.

    The right meds can help and research in this area continues. I hang out with a couple of cardiologists quite a bit and have discussed the meds at length - they are a management tool for cholesterol rather than a magic pill. Not everyone is the same in terms of treatments and outcomes. They do have side effects to be aware of though the bad stuff is pretty rare and should be caught early if you're being monitored by your doc as anyone on meds should be doing.

    The bizarre is the retreads among us who are fat and out of shape but won't take meds or do anything about their condition because "muh meat... and muh taters... exercise hurts my _______"

    How weak. Can't fix stupid and they'll just die younger than they should. Sucks for their kids and grandkids.
    Curious what you did to correct?
     
    Changing all red meat (virtually all) to wild game dropped my cholesterol over 30 points, and dropped my wife's score over 60 points. She has hereditary cholesterol issues, and had higher numbers than me to start.

    A friend with cancer has a holistic doctor who has told him "no grocery store meat". Organic, grass fed/finished only. I send him home with at least one deer every year, and wild hog when I can get it.
    that sounds good. i kinda wonder about the deer that feed in industrial ag areas. bigger and with more fat i believe. seems they would eat the same poison that is fed in feed lots/standard beef production? also,believe that the "bad" chems accumulate in fat more than muscle. so,i wonder whether venison in some areas might not be any better than standard beef,which i know has problems. am i right? or am i FOS?
     
    Curious what you did to correct?
    Mostly laid off meat and dairy. At first nothing happened but after a few weeks I felt notably better and had lost about 10 lbs. Kept going until my next physical a few months away and a couple of numbers (cholesterol was one) that had me on “double secret probation” had fallen back in line. I ate what I wanted and I love a lot of Asian, Indian, and middle eastern food much of which is vegetarian (or vegan) so that made it easy. Honestly meat was the easiest to give up, though I miss cooking it. Cheeses and butter were the hardest to give up and have sucked me back some in the last year or two. I did make an effort to move more - more hiking, skiing and outdoor stuff - never was a gym or regimented workout type. The big shift though was that this experiment has made me think about what I eat a lot more.
     
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    that sounds good. i kinda wonder about the deer that feed in industrial ag areas. bigger and with more fat i believe. seems they would eat the same poison that is fed in feed lots/standard beef production? also,believe that the "bad" chems accumulate in fat more than muscle. so,i wonder whether venison in some areas might not be any better than standard beef,which i know has problems. am i right? or am i FOS?

    I think the most significant thing is no antibiotics or growth hormones.

    Deer also are browse feeders. Even in the presence of corn/wheat/soybeans, a significant portion of their diet will be native vegetation. I fun a couple of feeders on my hunting property. I feed enough for them to swing by for a snack, but it's not enough for even a single deer to survive on. Plus, they have to compete with the turkeys, bears, coons, groundhogs, and rabbits to get a portion.
     
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    Those who are on PCSK9 inhibitors, which one do you take, do they work and do/did you have any unpleasant side effects?

    I am on Repatha. Zero side effects for me and astoundingly improved my cholesterol and lipid ratios. So much so that I modified from injecting every 2 weeks to every 3 weeks. I cannot and will not take a statin. The PCSK9 inhibitors look to be a very good step forward. Only thing I don't like about it is they no longer off vials of the med for me to do my own thing....only epi pen style auto injectors and I hate those bastards.
     
    So why the big thing against statins. Someone school me. I am afraid that my genetics are going to play a role. Eating whatever I wanted the first 40 years probably didn’t help but considering my grandparents and my dad were/are/have been on statins most of their lives then I’m afraid I am gonna have to be as well. I did the diet and workout thing and was doing great before Covid, as in finally got my numbers back in line, but just barely and I was working out like a mad man. Then Covid hit and the gyms shut down, you guys know all the BS that happened. And I fell of the wagon. Back on statins I went. I haven’t had my cholesterol checked in awhile but I’m going to assume that not much has changed. And even if I start back to working out like I did when I was young, it’s not likely to make much difference. But I got to try.

    @Herb Stoner so you eat salad and veggies mainly? No meat at all? Geez that’s gonna be tough. I love meat and cheese and pizza!
     
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    I'm pretty early into this. No meds for me till I get a better understanding of what is going on. Made a bunch of diet changes. I always tried to eat reasonably well and chose lower fat stuff because it sounded like a good idea. In the last few years I was reading a lot on how the dietary guidance that has been around for a long time was wrong and fat isn't that bad for you and keto diets with lots of meat was good for you etc. So I said great!! I LOVE meat and butter and eggs. I could be happy just eating those things. Been eating 2 eggs every morning for breakfast for a few years. Really into cooking so lots of smoked meats and cheeses.

    I'm 52 now and hadn't been to a doc in about 7 years. In the spring I wasn't feeling great so I started paying attention. Blood pressure was creeping up. Blood test came back cholesterol in the very high range, high LDL, low HDL, normal range Tri G. My grandfather had a bunch of heart issues but checked out early with a hospital acquired staff infection. My dad is pushing 80 but has been on statins for the last 40ish years, (no side effects).

    Like I said, I made a bunch of diet changes and I'm due for some new blood work. I read intermittent fasting can help your liver metabolize cholesterol. It was stated that our bodies evolved not having a steady flow of food to constantly be processing. Kinda makes sense to me and I don't really need a breakfast so I don't eat anything from about 6 at night till noon the next day. Also, Omega3 is supposed to help so fish oil supplements daily now and a nice silver lining here is I LOVE sushi. I don't know where my cholesterol currently is but I feel much better than I did a few months ago.

    I have no base line for Apo B in my blood work and that will be the most important thing I'll be looking for. If Apo B is low then the LDL cholesterol level may not be all that important to lower. If it's high, especially after the diet changes, I'll be assuming I have the genetics for atherosclerosis and probably be getting on a PCSK9 inhibitor.
     
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    @Herb Stoner so you eat salad and veggies mainly? No meat at all? Geez that’s gonna be tough. I love meat and cheese and pizza!
    As far as typical salads with lettuce and some dressing - not so much. Had a salad (Japanese-style) a couple of nights ago that was soba noodles with veggies and a tasty peanut dressing / sauce - no lettuce involved. I do eat some fish so we had cedar planked salmon with asparagus last night. We cook a lot with various veg, legume, starches and pasta - once you get going with it there are a lot of delicious options - especially if you like any asian, indian, or middle eastern foods. I love pizza having lived along the swiss / italian border and we make wood-fired pizza on our Big Green Egg - just a little cheese though and some veggies (shrooms, tomatoes, basil, figs, pears, etc.) Never liked the overloaded American-style pizza anyhow.

    I grew up on a ranch so most dinners had a big ol' slab of meat as the main event. We sold the ranch property to developers when I was in my late teens and my career later took me all over the world and I got to eat all kinds of local foods and found many of them wonderful. Leading up to the time I dropped meat and dairy, we had gotten to where we didn't eat with a large portion of meat as the feature for very many meals and at least a couple of dinners a week had no meat so the switch for me wasn't as dramatic. For most of my adult life I ate very little fast food or chain restaurant fried BS. Its been about a decade now and I do know that the more I eliminate meat and dairy the better I feel - much better.

    I expect my genetics will catch up with me at some point - at least with cholesterol and that's fine. If I can stay off meds until my late 60s or 70s I'll be happy. My whole goal is to have as much energy and enjoy life as much as I can - especially now with grandkids. So far - so good...
     
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    As far as typical salads with lettuce and some dressing - not so much. Had a salad (Japanese-style) a couple of nights ago that was soba noodles with veggies and a tasty peanut dressing / sauce - no lettuce involved. I do eat some fish so we had cedar planked salmon with asparagus last night. We cook a lot with various veg, legume, starches and pasta - once you get going with it there are a lot of delicious options - especially if you like any asian, indian, or middle eastern foods. I love pizza having lived along the swiss / italian border and we make wood-fired pizza on our Big Green Egg - just a little cheese though and some veggies (shrooms, tomatoes, basil, figs, pears, etc.) Never liked the overloaded American-style pizza anyhow.

    I grew up on a ranch so most dinners had a big ol' slab of meat as the main event. We sold the ranch property to developers when I was in my late teens and my career later took me all over the world and I got to eat all kinds of local foods and found many of them wonderful. Leading up to the time I dropped meat and dairy, we had gotten to where we didn't eat with a large portion of meat as the feature for very many meals and at least a couple of dinners a week had no meat so the switch for me wasn't as dramatic. For most of my adult life I ate very little fast food or chain restaurant fried BS. Its been about a decade now and I do know that the more I eliminate meat and dairy the better I feel - much better.

    I expect my genetics will catch up with me at some point - at least with cholesterol and that's fine. If I can stay off meds until my late 60s or 70s I'll be happy. My whole goal is to have as much energy and enjoy life as much as I can - especially now with grandkids. So far - so good...
    How old are you? Im 44 and I’m from the south so you know fried food is like a staple.